Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.
Daneshkhah F, Allahverdipour H, Jahangiri L, Andreeva T
BACKGROUND: Female genital mutilation is an intentional inhumane procedure that threatens girls and women’s health. It is especially widespread in developing countries due to cultural, traditional and religious preferences. The aim of the current study was to investigate how circumcision affects women’s sexual function. METHODS: This cross-sectional study was conducted in the urban and rural area of Piranshahr County, Iran, in 2015 among convenience samples of 200 women, 15-49 yr old, who were applying to health care centers for receiving routine health care services. Data collection was conducted with the use of a self-administered written questionnaire to assess female sexual function, mental well-being, and quality of life. RESULTS: Significant differences were found between circumcised and non-circumcised women in total score of female sexual function index (FSFI) in domains of desire, arousal, vaginal moisture, orgasm, satisfaction, and pain [(P<0.001), MD(95%CI)=5.64(3.64 to 7.64)] and based on Hotelling’s T-square, significant differences were found in dimensions of quality of life and FSFI. CONCLUSION: The revealed sexual dysfunction among mutilated women gives ground to require that public health systems take actions aimed at implementing special sexual education program to improve sexual functions of mutilated women and changing beliefs and social norms in the community level.
Int J Gynaecol Obstet. 2017 Feb;136 Suppl 1:60-64. doi: 10.1002/ijgo.12051.
Psychological and counselling interventions for female genital mutilation.
Smith H, Stein K.
Women and girls living with female genital mutilation (FGM) are more likely to experience psychological problems than women without FGM. As well as psychological support, this population may need additional care when seeking surgical interventions to correct complications of FGM. Recent WHO guidelines recommend cognitive behavioral therapy for women and girls experiencing anxiety disorders, depression, or post-traumatic stress disorder. The guidelines also suggest that preoperative counselling for deinfibulation, and psychological support alongside surgical interventions, can help women manage the physiological and psychological changes following surgery. This synthesis summarizes evidence on women’s values and preferences, and the context and conditions that may be required to provide psychological and counselling interventions. Understanding women’s views, their own ways of coping, as well social and cultural factors that influence women’s mental well-being, may help identify the types of interventions this population needs at different times and stages of their lives.
Female genital mutilation and mental health: how can research help the victims?
In their paper on mental health problems associated with female genital mutilation (FGM) Knipscheer et al1 concluded that ‘a considerable minority group, characterised by infibulated women who have a vivid memory of the circumcision and cope with their symptoms in an avoidant way, reports to experience severe consequences of genital circumcision’.
I welcome the authors’ brave contribution to this crucial but under-researched topic, and appreciate their attempt at exploring the relationship between FGM and psychopathology in circumcised migrant women. However, despite their genuine acknowledgement of the limitations of their findings, it is my opinion that their paper suffers from various shortcomings which I will try to address here…
Female genital mutilation in a young refugee: a case report and review
Suardi E, Mishkin A & Henderson SW
Female genital mutilation (FGM) is a widespread practice affecting up to 140 million girls and women worldwide (World Health Organization, 2008a). A substantial advocacy literature reports long-term psychological consequences of FGM, but there is little in the psychiatric literature to document this (Behrendt & Moritz, 2005). Within the broader psychiatric literature on refugee mental health, there are debates about the general validity of psychiatric diagnoses in refugee communities, including somatic disorders and posttraumatic stress disorder (Summerfield, 2008). We present the case of a young woman with a history of FGM, who was repeatedly hospitalized for gastrointestinal complaints of unclear etiology and discuss how her case illustrates the diagnostic and cultural complexity of the psychosocial consequences of FGM and political asylum-seeking.
Arch Sex Behav. 2012 Jun;41(3):725-30. Epub 2011 Aug 12.
Cosmetic clitoridectomy in a 33-year-old woman.
Veale D, Daniels J.
NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and The Institute of Psychiatry, King’s College London, 99 Denmark Hill, London, SE5 8AZ, UK. David.Veale@kcl.ac.uk
Arch Sex Behav. 2012 Jun;41(3):735-6.
Arch Sex Behav. 2012 Jun;41(3):731-4.
The Female Genital Mutilation Act (2003) in England allows for mental health exceptions for cosmetic surgery resulting from perceived abnormality. Similar legislation exists in other countries. There are no reported cases of clitoridectomy for cosmetic reasons or any discussion in the literature of mental health exceptions to the Act. This is a single case report on a 33-year-old married, heterosexual woman who had already had a cosmetic labiaplasty and was seeking a clitoridectomy for aesthetic reasons. At assessment, there were no psychiatric contra-indications or unrealistic expectations and the patient proceeded with a clitoridectomy. At 9 and 22 months follow-up, she was reassessed and was very pleased with the outcome. There were improvements in the satisfaction with her genital appearance, sexual satisfaction, and quality of life related to body image. Assessments for cosmetic clitoridectomy will continue to be rare, but this case may provide some guidance for practitioners who are confronted with such requests for body modification. However there remains only limited understanding of the motivation for such a request.